GN 00204: Applications

Effective Dates: 02/22/2013 - Present

TN 71 (11-08)

A. Background

Applications under Title II cover all classes of Title II benefits, e.g., the benefit types described in 202(a) through 202(l) and 223 of the Social Security Act for which the claimant is eligible on all Social Security numbers (SSNs). Also, a claimant is "deemed" to have filed an application for both reduced RIB and reduced spouse's benefits if eligibility for both exists in the first month of entitlement (MOET). See GN 00204.020 for the scope of the application. Therefore, policies and procedures in this section ensure that entitlement to RIB is explored whenever a spouse's application is filed.

When an application is filed, the Modernized Claims System (MCS) performs various checks against information contained in our records to verify the identity of the claimant and to determine if all entitlement factors are met. A formal initial determination is made and the claimant receives a notice that includes appeal rights. All of these safeguards protect the claimant's rights to benefits. Therefore, a certified earnings record (e.g., Informational/Certified Earnings Record System or ICERS) must be obtained and reviewed to determine insured status (I/S).

B. Policy

Determine whether entitlement to RIB benefits exists when the claimant files an application for spouse's benefits by:

taking the RIB application; or
obtaining a certified earnings record, such as, ICERS, on the claimant's own SSN to document the lack of insured status in the spouse's application. The types of certified earnings records are listed in GN 01010.009A.1.

The policy on the scope of the application does not require routinely taking a RIB application in every situation when a spouse application is filed; nor does it provide for informal disallowances for Title II applications. In fact, a spouse claimant at or past Full Retirement Age (FRA) has the right to restrict the application to exclude RIB. However, always take a RIB application in a reduced benefit situation when the spouse is insured for RIB as the "deemed filing" provision applies. See GN 00204.020F for the policy on the deemed filing rule.

C. Procedure – take the RIB application

Take the RIB application and process it using routine procedures whenever entitlement to RIB is questionable or extensive development is required to determine entitlement. (See GN 00204.004D for another method for determining if RIB entitlement exists.)

D. Procedure – obtain a certified E/R

1. Options

Several options can be used to obtain a certified E/R without completing the RIB application. (See GN 01010.009A.1. for the types of E/Rs). Follow the instructions in GN 00204.004E when using Earnings Computation (EC) screens via MCS.

2. Documentation – spouse not entitled to RIB

Document the spouse's application electronically (e.g., MCS Report of Contact (RPOC) screen) to show clearly the following information about non-entitlement to RIB:

The type and date the certified E/R was received;
Whether lag earnings, military service (MS) credits, etc., were considered; and
The number of quarters of coverage (QCs) shown on the certified E/R;

E. Procedure – EC screens

Use the Production Region to request EC screens to determine insured status (I/S) (see MSOM MCS 001.003, MCS System Menu, and MSOM MCSEC 001.005, EC Request) so that claimants can make informed choices about whether to file for RIB when a spouse's application is filed. Information on I/S is located on the Insured Status (DEI1) and Earnings Data (DEIE) screens.

NOTE: The MCS Training Region does not perform all the automatic functions necessary to produce a certified E/R in all cases, so it should never be used to obtain one.

If there is an EC processing limitation that cannot be overridden and a certified E/R is not immediately available, obtain an uncertified E/R (Summary Earnings Query (SEQY), Detailed Earnings Query (DEQY), etc.) and review earnings information with the claimant. Request a certified E/R via the ICERS to document the claims file on I/S.

In determining if I/S is met, be sure to:

Consider lag, MS and/or Railroad (RR) QCs; and
Obtain pre-1956 earnings information (if needed) via the system through the Office of Earnings Operation (OEO) when a certified E/R has been requested or EC screens are used. Otherwise, use MCS to request OEO feedback to determine the number of pre-1956 QCs.
Develop and effectuate a RIB application if I/S is met.

1. Insured status not met – RIB application filed

If I/S is not met, but the claimant still chooses to file for RIB, a RIB application must be taken and effectuated as a denial. Issue a RIB denial notice to the claimant in all cases.

2. Insured status not met – no RIB application filed

If I/S is not met and the claimant chooses not to file for RIB, document earnings gaps and unusual earnings fluctuations on the Remarks (RMKS) screen of the claimant's spouse application or, in rare instances, a SSA-795.

Document the information from the earnings record on the RPOC on the claimant's spouse application as follows:

ISSUE—“NO I/S”
REC—Enter the date the earnings information is received
REMARKS—Enter the type of E/R used to determine the QCs (e.g., ICERS, DEI1, DEIE), and other considerations (lag, MS, pre-1956 allegation, and number of QCs (e.g., DEIE, lag, 25 QCs); or,

Develop and effectuate the spouse application following routine procedures. Send paragraph CLOR20 in non-MCS clearance cases. Use paragraph CLOR20 in MCS clearance cases.